Docket: IRS-2009-0008 

Request for Information for Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 

2008 

Comment On: IRS-2009-0008-0001 

Request for Information Regarding the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction 

Equity Act of 2008 

Document: IRS-2009-0008-0020 

Comment on FR Doc # E9-09629 

Submitter Information 

Name: John S Anderson 

Address: 

Saint Louis Park, MN, 

Organization: Minnesota Neurotherapy Institute 

General Comment 

Please see attachment for comments. 

Attachments 

PUBLIC SUBMISSION 

As of: May 28, 2009 

Tracking No. 809ad4c2 

Comments Due: May 28, 2009

IRS-2009-0008-0020.1 Comment on FR Doc # E9-09629
Comments regarding Regulatory Guidance USCG-2007-27022 

page 19157, II B specific areas 1 and 4

I am a Licensed Alcohol and Drug Counselor (LADC) in Minnesota providing EEG 

biofeedback treatment to individuals with Addiction Disorders and co-occurring Mood 

Disorders. EEG biofeedback is an empirically validated and widely recognized effective 

non-medication treatment for addictions with many peer reviewed, published, controlled 

studies demonstrating efficacy. This approach also works for ADHD, depression, 

anxiety, headache including migraine, as well as other disorders. There are over 50 

published studies evaluating EEG biofeedback in the treatment of ADHD, Substance Use 

Disorders and Autism. A recent review of this literature concluded “EEG biofeedback 

meets the American Academy of Child and Adolescent Psychiatry criteria for” Clinical 

Guidelines “for treatment of ADHD.” This means that EEG biofeedback meets the same 

criteria as medication for treating ADHD, and that EEG biofeedback “should always be 

considered as an intervention for this disorder by the clinician”. This service has been 

denied by United Behavioral Health, Blue Cross, Health Partners and many other 

managed care organizations.

This is limitation of an effective and validated treatment for a mental health problem. The 

reasons given by the insurance companies for this denial fell into two categories: 1) our 

company does not cover biofeedback for Mental Health problems or 2) there is not yet 

sufficient evidence for the efficacy of EEG biofeedback. As such, they are using 

evidence-based criteria that are far more restrictive for mental health services than the 

criteria which are used for medical/surgical services. There are many routine medical and 

surgical procedures which have far fewer controlled studies about their efficacy than does 

EEG biofeedback. Additionally, medications are routinely prescribed for “off label” uses 

with absolutely no empirical evidence supporting this use. However, insurance 

companies routinely cover these prescriptions without any call for research validation. 

I believe that the parity regulations, based on legal reviews of the parity statute should 

require that employers and plans pay for the same range and scope of services for 

Behavioral Treatments as they do for medical and surgical benefits and that a plan cannot 

be more restrictive in their managed care criteria and reviews for MH and SA disorders 

when compared to Med Surg. Today plans are being more restrictive in how they review 

evidenced-based Mental Health and Substance Abuse Treatments when compared to Med 

Surg treatments. This violates both the intent and letter of the parity statute and we hope 

that the regulations will clarify that this can't continue.

In Minnesota, insurance is routinely denied for effective mental health interventions 

because they are considered “investigational” even though they have more published 

support than comparable medical interventions. In the field of substance abuse treatment 

this is especially important because a non-drug approach is highly desirable in these 

cases. Treating drug abuse with another drug is simply counter to good mental health 

practice. Heroin and Methadone were both developed to treat opiate addictions and we

all know the results of those failed experiments. A non-drug approach that has proven 

efficacy should be utilized whenever possible for this condition.